Giant Internal Carotid Artery Pseudoaneurysm Following Cheek Stab Wound

This report describes a 60-year-old female presenting with recurrent oral bleeding for 1.5 months after a fall-induced right buccal trauma, during which a branch pierced her check. After undergoing external debridement and suturing at a local hospital without intraoral repair, she developed a right buccal mass and severe anemia. Clinical examination revealed facial asymmetry, a right buccal depression with hyperpigmented skin, and an irregular cord-like scar-accompanied by a tender, nonpulsatile mass anterior to the right pterygomandibular ligament. Laboratory tests confirmed severe anemia (hemoglobin 55.8 g/L). Contrast-enhanced CT of the maxillofacial region identified a 40×27 mm pseudoaneurysm in the C1 segment of the right internal carotid artery, with adjacent soft tissue hematoma. Subsequent neurosurgical consultation confirmed the diagnosis of stab wound-induced internal carotid pseudoaneurysm. The patient underwent urgent transcatheter stent-assisted embolization under general anesthesia, and follow-up CT angiography demonstrating resolution of the pseudoaneurysm and patent carotid artery.